Acquired Eustachian tube atresia following turbinoplasty: multimodal surgical reconstruction, clinical outcomes, case series, and literature review.

BACKGROUND

Acquired atresia of the Eustachian tube (ET) is an uncommon but debilitating condition that can significantly impair middle ear ventilation and drainage, leading to chronic otitis media, conductive hearing loss, and aural fullness. Despite its impact, diagnosis and management remain challenging, with limited literature on standardized approaches.

OBJECTIVE

This case series aims to describe the clinical presentation, imaging findings, surgical management, and outcomes of three adult patients with acquired ET atresia treated using multimodal surgical interventions, including balloon dilation, laser-assisted dissection, and microdebrider techniques.

METHOD: We retrospectively reviewed three adult cases presenting with persistent otologic symptoms refractory to conventional medical and ventilation tube therapy. Diagnosis was confirmed through endoscopic evaluation and imaging. Surgical intervention targeted restoration of ET patency using endoscopic and microscopic techniques tailored to the anatomical findings of each case.

RESULTS

All patients demonstrated symptomatic improvement postoperatively, with reduced otorrhea, otalgia, and improved middle ear aeration, and improvement in ETDQ-7 average score. Use of adjunctive techniques such as balloon dilation and short-term stenting helped maintain patency and enhance outcomes. No major complications were noted.

CONCLUSION

A multimodal, individualized approach to acquired ET atresia can provide significant clinical benefit. Adjunctive use of balloon dilation, laser, and microdebrider techniques enhances surgical success. Further research is needed to determine long-term outcomes and optimal treatment protocols.